title: Skin manifestations of outpatient adverse drug events in the United States: a national analysis.
abstract: BACKGROUND
  Cutaneous reactions to drugs are among the most common clinical manifestations of adverse drug events (ADEs); however, data on outpatient cutaneous adverse drug events (CADEs) are limited.
  
  
  OBJECTIVE
  To provide national estimates of outpatient CADEs and determine their most frequent causes.
  
  
  METHODS
  Outpatient CADEs recorded in the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) between 1995 and 2005 were analyzed. The national incidence of outpatient CADEs in those seeking medical attention in the United States was estimated, and the common medication classes implicated with CADEs were identified.
  
  
  RESULTS
  There were a mean annual total of 635,982 CADE-related visits, resulting in an annual incidence of 2.26 CADEs per 1,000 persons. Patients took an average of 2.2 medications in addition to the one causing the CADE. The incidence of CADEs increased with age, with a peak in the age group from 70 to 79 years. The medications most frequently causing a CADE were antimicrobial agents. Dermatitis and urticaria were the two main types of skin reactions reported.
  
  
  CONCLUSIONS
  CADEs occur less frequently in outpatients than in inpatients and result in few hospital admissions. Physicians must be particularly cognizant of the occurrence of CADEs when prescribing antimicrobial agents.
authors.affiliation: Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Koelblinger
authors.forename: Tushar S
authors.initials: TS
authors.lastname: Dabade
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Gustafson
authors.forename: Scott A
authors.initials: SA
authors.lastname: Davis
authors.forename: Brad A
authors.initials: BA
authors.lastname: Yentzer
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Kiracofe
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003875:Drug Eruptions / Q000175:diagnosis*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D014481:United States; D055815:Young Adult